<link rel="stylesheet" type="text/css" href="<?=base_url();?>css/style_validate.css" />
<script type="text/javascript" src="<?=base_url();?>js/jquery/jquery.js"></script>
<script type="text/javascript" src="<?=base_url();?>js/validate/jquery.validate.js"></script>
<script type="text/javascript" src="<?=base_url();?>js/validate/jquery.validate-rules.js"></script>
<div id="wrapper">
<?php
$attributes = array('id' => 'form-paypal');
echo form_open($enlaceformpaypal, $attributes);
?> 
<h2>Formulario de Pago</h2>

<div class="precioPlan">
    <h2>Suscripcion: <?= $susc; ?> </h2>
    <h2>Total a Pagar: <?= $precio; ?></h2>
</div>

<div class="field">  
    <label for="name">Nombre<span style="color:red">*</span> </label>  
    <input class="input" id="name" name="name" type="text" value="<?= $data->name; ?>" />
    <?php echo form_error('name'); ?>                        
</div>  

<div class="field">  
    <label for="user">Usuario<span style="color:red">*</span> </label>  
    <input class="input" id="user" name="user" type="text" value="<?= $data->username; ?>" />
    <?php echo form_error('user'); ?>                        
</div> 

<div class="field">  
    <label for="email">E-mail<span style="color:red">*</span> </label>  
    <input class="input" id="email" name="email" type="text" value="<?= $data->email; ?>" />
    <?php echo form_error('email'); ?>                        
</div>  

<!-- Datos Nuevos -->
<div class="field">  
    <label for="address">Dirección<span style="color:red">*</span> </label>  
    <input class="input" id="address" name="address" type="text" value="<?php echo set_value('address'); ?>" />
    <?php echo form_error('address'); ?>                        
</div> 

<div class="field">  
    <label for="city">Ciudad<span style="color:red">*</span> </label>  
    <input class="input" id="city" name="city" type="text" value="<?php echo set_value('city'); ?>" />
    <?php echo form_error('city'); ?>                        
</div> 

<div class="field">  
    <label for="estate">Estado<span style="color:red">*</span> </label>  
    <input class="input" id="estate" name="estate" type="text" value="<?php echo set_value('address'); ?>" />
    <?php echo form_error('estate'); ?>                        
</div> 

<div class="field">  
    <label for="zp">Codigo Postal<span style="color:red">*</span> </label>  
    <input class="input" id="zp" name="zp" type="text" value="<?php echo set_value('zp'); ?>" />
    <?php echo form_error('zp'); ?>                        
</div>

<div class="field">  
    <label for="country">Pais<span style="color:red">*</span> </label>  
    <input class="input" id="country" name="country" type="text" value="<?php echo set_value('country'); ?>" />
    <?php echo form_error('country'); ?>                        
</div>
 
<input type="hidden" name="cmd" value="_s-xclick">   
<input type="hidden" name="return" value="<?=base_url();?>index.php/suscripciones/pagorealizado/">
<input type="hidden" name="cbt" value="Finalizar proceso">
<input type="hidden" value="2" name="rm">
<input type="hidden" name="hosted_button_id" value="<?=$hosted_button_id;?>"> 
<input type="submit" name="submit" class="submit" id="reg-boton" value="Suscribirse">
</form> 
</div>
<? $this->load->view('footer'); ?>